Withdrawals after five days without any methadone or heroin?

[beena]

SWIM stopped taking her methadone last Tuesday after being on 50mls for two months and using heroin and opiates on top. She decided as she hadn't been able to stop using with the methadone and as she is going away soon to a place where she has a good chance of getting support and hopefully getting clean she would use morphine tablets (MST) to come off methadone and then taper off the morphine (she has ten days to do so before her flight).
SWIM started off badly on Tuesday by taking 900mg of morphine but since then she has done surprisingly well and yesterday she only took 60mg of morphine and 50mg of tramadol. She kept waiting and waiting for the withdrawals to hit but nothing seemed to be happening....until this evening that is.
Today is day five without methadone and she got up late feeling a bit shivery....took two MSTs (same as yesterday) and one tramadol (50mg) so she didn't think she was gonna need to take any more, but she's just been feeling worse and worse as the day/night has gone on.
Its now 2am in the morning and SWIM can't sleep: her whole body aches but especially her legs, she has a bit of a sore throat and feels generally a bit flu-ey and under the weather. Is this withdrawals from methadone? Should SWIM be getting these on day five of the withdrawal? Why hasn't she felt ill before this? And also if this is the start of withdrawals how long do SWIYs think they will last. So far this evening SWIM has had 300mg of morphine and 100mg of tramadol but she doesn't feel like she's had anything. I mean SWIM still feels quite ill. If it is withdrawal, shouldn't the amount of morphine she's had counter it? At this rate SWIM is gonna run out of morphine before she's had a chance to cut back on it - then she really will be in trouble.

[Laszlo1]

well if swim took 900 (omg!) mg of morphine one tuesday, this swim can't see how that would help someone's withdrawls tonight, which is sunday, unless swim is too drunk to know what day it is. (which is entirely possible). Woops, swim didn't read that you took 100mgs of morphine today.

regardless, swim, although he has very limited first hand knowledge of opiates, has read on d-f that methadone w-ds are awful! So in swims mind, it's very possible that the wds of methadone are too intense to be counteracted with 100mg.

Swim apologizes for any erroneous advice/opinions, he's really quite drunk, but he has only good intentions. He hopes you just ride out the wds, addiction is awful, and best to be done with, but he's a hypocrite. =/

[IkBenDeMan]

Isn't tramadol a partial antagonist as well? If so, it could be what is making you feel sick... if you're dependant on methadone and take a partial antagonist... you won't feel good.

[On The Nod]

The worst part of a methadone withdrawal according SWIMs nurse is 4-8 days into the process, so what youre experincing is natural.

900mg of morphihne will of course keep swiy feeling sweet, Beware after SWIY made that drop in morphine prehaps SWIY is withdrawing of that as well.

SWIM reccomends getting back on a stable methadone dose, back on 50-60mls, and letting a professsional help SWIY, the only way in this situation.

Reputation Comments on this post:

good sensible advice.

[beena]

Oh ... it's been a month since SWIM originally posted regarding withdrawals ... SWIM got through the worst of it by using morphine pills (more sensibly than 900mg at a time!) and got right down to only using 30mgs of morphine then she switched to dihydrocodeine and then she came off everything. SWIM has been off methadone over a month now and off heroin over three weeks. SWIM has been staying with her folks (and seeing some really good friends too) in Jersey so she's been out of danger as far as relapsing goes. Tonight SWIM is flying back to the UK though so that will be the test SWIM guesses as far as staying clean goes. If SWIM does screw up royally then she guesses methadone may be a long-term solution (or even rehab, SWIM has never tried that), but that's a worse case scenario. SWIM is gonna try and concentrate on her course and get involved in as many (productive) activities as possible to keep herself busy. Other than that time will tell ....

[On The Nod]

Gee, Good luck with that swim cant lie its pretty hard staying clean, well done on the detox, the number of times swim has royally cocked up detoxes is insane, many a time swim has clucked for 7 days only to score when SWIM began to feel better, didnt fully understand addiction in them days though

[Lisa J]

Good luck & well done SWIBeena SWIM is pleased the MST helped, just be on your guard, SWIM did very well for almost a year but is now slipping & sliding towards addiction again
SWIM thinks part of the problem is that it's so easy to get away with "little slips" while on methadone, she got on much better in the past when she just detoxed using MST, but whatever the method used to clean up us SWIMMERS must never forget to keep working at it, it's when you forget this that it can start to go wrong.
Keep up the good work and be proud of what SWIY has achieved so far

[wopa]

wow why are you coming back to the u.k sounds like you are better off staying away swim had a long hard stint on smack and is now on 130ml of the methodone reduced from 180ml aday and would kill for the chance to brake free

[Dickon]

Just to add my two cents. It may or may not be true that....

It is thought by some that the dose ratio between methadone morphine goes on a sliding scale. I'll just google the standard equi-analgesic doses. Here we are: oral morphine and oral methadone note.

24hr morphine dose in mg : Conversion ratio
<30 2:1 (morphine:methadone)
31-99 4:1
100-299 8:1
300-499 12:1
500-999 15:1
1000+ 20:1

[Reference: Methadone Dose conversion Guidelines: Drs Kwill & Kuderer]

Note that this table has to be approximate, unless 30mg of morphine is worth 15mg methadone[shut up pedants. I'm correcting the < to <=], but 31mg morphine is worth 7.75mg etc.

I can verify that when I was on about 60mg of morphine, 30mg methadone felt similar. When I was using 200-700mg methadone day, I took 4.5 grammes of morphine [2,000mg and 2,500mg some way round and seperated by a few hours, and didn't feel much, at 20-1 that would make 225mg methadone, which was only just over my minimum tick over dose. They were MST 200s and 100s, but I did chew them thoroughly. I was really disappointed. It was meant to have been a treat!]. So my own experience is that there is approximate truth to these ratios. So 50mg of methadone = 750 morphine, or 1000 morphine [as I pointed out the table is not a true function, and the inverse is to give it it's technical term a multi-function]. So what you probably thought was a super-high 900mg morphine was actually about what you needed. 300mg equates to 25 mg methadone on this chart. I personally am surprised by this as I would rate 300mg as at least as good as 50mg methadone. But my experience is heuristic from a sample of one, and I guess the table above is more likely to reflect the average conversion rates.

Hope that helped a little

[smiles and departs to continue his current withdrawal with a plug for his own thread: "screaming in the night air : etc." How else will I climb up this greasy pole and drop the demeaning "newbie" title? <grins once again en facon Cheshire cat and disappears, leaving just a faint grin hovering in the air>]

Dr D

Dickon added 2 Minutes and 1 Seconds later...

P.S. I must correct something. The thing is a true function, it's simply not an invertible one!